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Frontiers in Neurology


Original Research ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Neurol. | doi: 10.3389/fneur.2019.01068

Correlation between cognitive impairment and diabetic retinopathy in patients with T2DM by 1H-MRS

Xuefang Lu1, zhi wen1, wei gong1, lanhua hu1, zhoufeng peng1 and  Yunfei Zha1*
  • 1Department of Radiology, Renmin Hospital, China

Objective: To explore the correlation between diabetic cognitive impairment(DCI) and diabetic retinopathy (DR) through examining the cognitive function and the metabolism of the cerebrum in T2DM by 1H-MRS.
Methods: 53 patients with T2DM were enrolled for this study. According to the fundus examination, the patients were divided into DR group (n=26) and T2DM without DR group (T2DM group, n=27). 30 healthy adults were selected as a control group (HC group, n=30). The cognitive function was measured by Montreal Cognitive Assessment (MoCA). The peak areas of N-acetylaspartate (NAA), Cho-line (Cho), Creatine (Cr) and Myo-inositol (mI), and their ratios were detected by proton magnetic resonance spectroscopy (1H-MRS). The difference analysis between the three groups was performed by one-way ANOVA. When p<0.05, LSD-t was applied. A partial correlation analysis (with age as a covariate) was used to analyze the correlation between metabolites in the DR group and MoCA scores. Among all T2DM patients, Chi-square test age, gender, education level, BMI, SBP, DBP, FPG, HbA1c, TC, TG, HDL-C, LDL-C, DR, and DCI correlation. Differences were statistically significant while P<0.05.
Results: 1. The scores of MoCA in the DR group or in the T2DM group were significant less than that in the HC group (F=3.54, P<0.05), and the scores of MoCA in the DR group were significant less than that in the other groups (F=3.61, P<0.05).
2. There were significant differences of NAA on bilateral hippocampus in DR patients ,T2DM patients and healthy controls(P<0.05).
3. The NAA/Cr is significant positive correlated with the score of MoCA in DR patients’ left hippocampus (r=0.781, P<0.01).
4. Chi-square analysis found that there was a correlation between DR and DCI (x2=4.6, df=1,p=0.032, plt:0.05). There was no correlation between other influencing factors and DCI (P>0.05).
Conclusion: DCI is closely correlated with the DR in patients with T2DM. The hippocampal brain metabolism may have some changes in two sides of NAA in patients with DR, 1H-MRS may provide effective imaging strategies and methods to early diagnosis brain damage and quantitative assessment cognitive function in T2DM.

Keywords: T2DM, diabetic brain damage, Diabetic Retinopathy, Hippocampus, 1H-MRS, MOCA

Received: 14 Apr 2019; Accepted: 23 Sep 2019.

Copyright: © 2019 Lu, wen, gong, hu, peng and Zha. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Mx. Yunfei Zha, Department of Radiology, Renmin Hospital, Wuhan, China,